Current Evidence and Diverse Perspectives on Attention-Deficit/Hyperactivity Disorder: A Systematic Review

Abstract

Introduction:  ADHD is one of the most common neurodevelopmental disorders in childhood and adolescence. Although the disorder starts to manifest early in childhood, a significant proportion of cases often persists into adulthood. ADHD negatively and significantly impacts social and occupational functioning and academic performance.  A number of extant theories and scientific evidence provide insight into the genesis and manifestations of ADHD and the attendant challenges of significant dysfunction that individuals may encounter at home, school, and the workplace. Method: This systematic review was conducted through a literature search for published peer-reviewed articles using standard PRISMA guidelines.  The goal of the study was to explore current theories, models, concepts, and risk factors about ADHD in published in peer-reviewed literature,. We made use of use several online databases— including PsycINFO, PubMed, Web of Science, ScienceDirect, and Medline in the process of searching for relevant studies. Relevant peer-reviewed publications since the 1980s when the term Attention-Deficit/Hyperactivity Disorder (ADHD) was introduced in DSM-III-R were included. Non-peer-reviewed publications, including dissertations,  editorials, commentaries, and materials published in languages other than English were excluded. Results and Discussion: The results of the review indicated that ADHD is characterized by a behavioral reaction that interferes with personal and social functioning. The factors associated with ADHD fall into several major thematic areas, including genetic and hereditary factors; dietary and nutritional factors; parenting and behavioral factors; adverse early life events, and high-risk environmental factors, crystallized by a number of developmental and behavioral theories. The review also identified a number of extant models and theories that attempt to explain the diverse perspectives associated with ADHD. Conclusion: This study has attempted to identify the major risk factors and diverse models and theories associated with ADHD.  The thematic risk factors include genetic and hereditary factors; dietary and nutritional factors; parenting and behavioral factors; adverse early life events, and high-risk environmental factors. The most prominent models identified include the biomedical model and the bio-psycho-social models, the latter being a more holistic approach which aims to treat both the patient and the disease. This review would provide an additional evidence base to individuals, families, and educators to make informed choices and decisions in the best interest of the affected children, including personal growth, healthcare, and medical needs, academic performance, and social skills development.